Use of individualized versus standard criteria to identify abnormal levels of heart rate or oxygen saturation in preterm infants.

Preterm infants' physiological indicators, such as heart rate, respiratory rate, and oxygen saturation levels, are routinely monitored by devices that can alert nurses to threatening changes in condition. Most Neonatal Intensive Care Units use standard criteria as alerting algorithms to determine when an alert should be issued, and these standard criteria have been adopted uncritically in studies of preterm infants. This article presents results from a study examining preterm infants' physiological responses to a gentle human touch (GHT) intervention in which we compared the use of standard and individualized criteria to define the percentages of abnormally low and high heart rates (HRs) and abnormally low oxygen saturation (O2 sat) levels before, during, and after periods of GHT. Results indicated that there were no differences in the percentages of abnormal HRs or O2 sat values between periods using standard criteria. However, using individualized criteria, there were significantly greater percentages of abnormally low heart rates and O2 sat levels during and after GHT periods as compared to baseline periods. The findings suggest that standard criteria may not be sensitive enough to detect subtle physiological responses to environmental stimuli such as touch. Moreover, consistent with the recognition of the value of individualized developmental care, these results suggest that the clinical effectiveness of individualized criteria for setting monitor alert limits merits further investigation.

Physiologic and behavioral effects of gentle human touch on preterm infants.

The purpose of this study was to evaluate the effects of a gentle human touch (GHT) intervention provided to 42 preterm infants (27-33 weeks gestational age), for 10 min, three times daily for 10 days. There was no significant difference in mean HR levels or in percent of abnormal heart rate (HR) or O2 saturation comparing 10-min baseline (B), GHT, and 10-min post-touch (PT) phases. There were significantly lower levels of active sleep, motor activity, and behavioral distress during GHT compared to B and P phases. There were no differences among the 42 infants in the GHT group and 42 infants in a randomly assigned control group on any outcome variable including weight gain, morbidity status, or behavioral organization. The findings suggest that GHT generally is a safe and soothing type of touch to provide to young preterm infants, but that individual infant responses to touch need to be continuously monitored by NICU staff and parents.

Factors associated with vagal tone responses in preterm infants.

The purpose of this study was to examine factors related to vagal tone (VNA) among preterm infants receiving a 10-minute gentle human touch (GHT) intervention three times daily for 10 days. VNA was measured continuously for 10 minutes before, during, and after each 10-minute GHT intervention. Findings indicated that there was a significant relationship between VNA and gestational age, although there were no relationships between VNA and measures of motor activity or behavioral distress. There was no difference in pattern of response to GHT or level of morbidity, average daily weight gain, or behavioral organization among infants with low, moderate, and high baseline VNA levels. There was no difference in VNA comparing infants in the GHT and control groups or during baseline, touch, and posttouch phases for infants in the GHT group. There is a need for further research to examine the usefulness of VNA as a measure of stress vulnerability among preterm infants.

Campus attitudes toward alcohol and drugs in a deep southern university.

In our zeal to deal with alcohol and drug abuse, we may have a distorted picture of what the majority of college students actually think about alcohol and drug use. Students in this study done at a public university located in the Deep South report being generally intolerant of substance abuse.